Essentials of pressure ulcer treatment. The diabetic experience

Diabetes accounts for over half of the lower extremity amputations in the United States. However, ulcers of the diabetic foot can often be treated successfully and amputations avoided.

To review treatment of diabetic foot ulcers.

Physicians must recognize the critical clinical and diagnostic features of ischemic and neuropathic ulcers. Therapy is directed towards vascular repair in the ischemic ulcer and relief of weight bearing through casting and shoes with molded insoles in the neuropathic ulcer. Sound principles of wound care apply to all ulcers.

For successful preventive foot care patients and physicians need to understand how and why ulcers form and the rationale for the types of footwear and care necessary to prevent ulcers.